Individual provider Active NPI

Henry Kenneth Fisher, M.D.

  • Pulmonary Disease Physician
  • Casper, WY
National Provider Identifier
1063517506
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
C28508 Issued in CA
Practice address
1230 E 1St St
Casper, WY 82601-2704
Phone
(307) 266-3174
Fax
(307) 261-6713
NPI assigned
Sep 13, 2006
Last updated
Oct 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X C28508 CA Primary

Addresses

Primary practice location

1230 E 1St St
Casper, WY 82601-2704

Mailing address

1230 E 1St St
Casper, WY 82601-2704
Phone (307) 266-3174

Other identifiers 1

IdentifierTypeStateIssuer
00C0285080MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304001306 CA Practitioner - Internal MedicinePractitioner - GastroenterologyPractitioner - Pulmonary DiseasePractitioner - Other (Physician) 8820986607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C28508CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tavarua Health Services Current Accepting new patients
El Dorado Community Service Center CurrentSince Oct 5, 2017 Accepting new patients
Los Angeles County Department of Public Health Current Accepting new patients
El Dorado Community Service Center Current Accepting new patients
Tavarua Rehabilitation Services Current Accepting new patients
West County Medical Clinic Current Accepting new patients
Desai Sleep PLLC Past Accepting new patients

Locations

4450 W Century Blvd
Inglewood, CA 90304
Phone (310) 671-0555

4023 Marine Ave
Lawndale, CA 90260
Phone (310) 675-9555

26460 Summit Cir
Santa Clarita, CA 91350
Phone (562) 916-7581

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: henryfisher-americanhealthservices@lacsapc.netsmartdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1063517506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E 1ST ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012704",
            "telephone_number": "307-266-3174",
            "fax_number": "307-261-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E 1ST ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012704",
            "telephone_number": "307-266-3174",
            "fax_number": "307-261-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "HENRY",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "C28508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C0285080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.